New Member Information New Member Join Ebenezer UCC Ebenezer United Church of Christ welcomes all with open arms! New Member Form Full Name * Preferred Name Baptized Yes No Address * Address Street Address Street Address Street Address Cont. Street Address Cont. City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Home Phone Mobile Phone Which number is best to contact you? Home Mobile Email Address Gender * Male Female Date of Birth * Marital Status Single Married Divorced Widowed Spouses Name Will spouse also be joining the church? Yes No If 'Yes', please submit a form for each of you. Occupation Minor Children Living at Home Name Baptized Yes No Date of Birth plus1 Add minus1 Remove Would you like to receive offering envelopes? YesNo Former Church Currently an active member? Yes No City State Zip For Consistory Records: Admitted By Transfer Profession of Faith Reaffirmation of Faith Ministry Interests Please indicate any interest in these ministry areas. Consistory Member Greeter Usher Choir/Singing Worship Leader Musician Sunday School Teacher Preschool Youth Group Christian Education VBS Ebenezers Closet Crafting and/or Quilting Women of the Church Instrument(s) Played Sunday School Teacher Adult Youth Elementary Other areas you may desire to serve: Other information you want to share about yourself (hobbies, interests, etc.) Are there any special needs/health issues we should be aware of? If you are human, leave this field blank. Submit
